Koshi women struggle to access safe abortion

By Shashidhar Parajuli, Biratnagar, May 18: Constitution guarantees safe motherhood and reproductive health as a fundamental right for women. However, the lack of legal clarity and social awareness continues to make access to safe abortion services challenging in Koshi Province. 

Stakeholders have stressed the need to address contradictions in the law, stating that while safe motherhood is defined as a right, the National Penal Code still interprets abortion as an offence, creating legal barrier for both women seeking services and healthcare providers.

Speaking at a programme titled “Implementation of Laws Related to Safe Abortion Services and the Current Situation”, held at Biratnagar on Sunday, experts highlighted the concerning state of safe abortion services in both Koshi Province and across the country.

Keshu Kafle of the Koshi Province Ministry of Health informed that 53 per cent of pregnancies in Nepal are unintended. 

“Among unintended pregnancies, 73 per cent result in abortion, and only 48 per cent of abortions are carried out in listed health institutions, while the remaining 52 per cent still occur through illegal and unsafe means,” she said. At present, Koshi Province has 281 listed safe abortion service centres.

Nepal still records 151 maternal deaths per 100,000 live births. In Koshi Province, the rate is even higher than the national average, standing at 157. Statistics show that unsafe abortion accounts for around seven per cent of total maternal deaths.

According to the annual report of the Office of the Attorney General for the fiscal year 2023/24, 27 abortion-related cases were filed across the country. Although this number may not appear large, experts said the fear created by such cases discourages many women from seeking legal services, pushing them towards unsafe alternatives.

Kailash Gurung, Judge of the High Court Biratnagar said local governments play a crucial role in reducing maternal mortality. 

He stressed that healthcare workers acting in good faith should not face legal obstacles and emphasised that legal action should proceed only after examining data and the realities on the ground. 

He also stated that all three tiers of government must become more responsible for ensuring safe abortion services.

During the discussion, senior gynaecologist Dr. Balakrishna Sah shared experiences of doctors being unfairly labelled as criminals due to misunderstandings of technical matters. 

According to him, problems arise when investigative authorities fail to distinguish between comprehensive abortion services and post-abortion complication management.

The issue of “media trial” was also raised seriously during the programme. 

Judge Gurung stated that media outlets often brand individuals as criminals immediately after arrest, even before a court verdict, causing irreparable damage to personal dignity and social standing. 

Chief District Officer of Morang, Yubaraj Kattel and Superintendent of Police Kabi Katwal stressed the need for sensitivity during investigations and stronger coordination between healthcare professionals and the administration.

The stakeholders concluded that safe abortion should be fully removed from the scope of criminalisation, contradictions between laws should be resolved, and the illegal sale of abortion-related medicines in pharmacies should be strictly regulated. 

Experts stated that safe abortion is not only a matter of women’s health rights but also a social justice, requiring meaningful coordination among police, the judiciary, healthcare workers, and the media.